A nurse in the respiratory unit is caring for client who has a past medical history of heart failure and is currently admitted for asthma exacerbation. When reviewing the provider's orders further clarification is needed for which of the following medications?
Prednisone
Metropolol
Labetolol
Albuterol
The Correct Answer is B
A) Prednisone:
Prednisone is a corticosteroid commonly used to reduce inflammation in conditions such as asthma. It is appropriate in this case for managing the asthma exacerbation, as steroids help to decrease airway inflammation and improve breathing. There is no immediate concern about prednisone in this client with both asthma and a history of heart failure.
B) Metoprolol:
Metoprolol is a beta-blocker, typically used for managing heart failure, hypertension, and arrhythmias. However, beta-blockers are generally avoided in asthma patients because they can exacerbate bronchospasm. In patients with asthma, beta-blockers can block beta-2 receptors in the lungs, leading to constriction of the airways and worsening respiratory symptoms.
C) Labetolol:
Labetolol is a beta-blocker with both alpha- and beta-blocking effects, which can help lower blood pressure and manage heart failure. While labetalol can also block beta-2 receptors, it has a relatively lower risk of causing bronchospasm compared to non-selective beta-blockers like metoprolol. However, it still poses some risk to patients with asthma. Given the patient's history of asthma, labetolol may still require caution, but it is generally considered safer than other beta-blockers.
D) Albuterol:
Albuterol is a bronchodilator used to relieve acute asthma symptoms and is commonly prescribed for asthma exacerbations. It works by stimulating beta-2 receptors in the lungs, leading to the relaxation of bronchial smooth muscles and improved airflow. In this case, albuterol is an appropriate medication for managing asthma exacerbation and should be used to relieve symptoms of shortness of breath and wheezing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Synchronized cardioversion: Synchronized cardioversion is indicated for unstable supraventricular tachycardia (SVT), especially when the client shows signs of hemodynamic instability, such as hypotension, altered mental status, or chest pain. This intervention delivers a timed shock to restore normal rhythm, prioritizing the client's immediate stabilization.
B. Adenosine infusion over 30 minutes: Adenosine is typically administered as a rapid intravenous push to terminate SVT by temporarily blocking atrioventricular nodal conduction. However, this client is unstable, and synchronized cardioversion is the preferred intervention in cases of hemodynamic compromise.
C. Immediate defibrillation: Defibrillation is used for life-threatening arrhythmias like ventricular fibrillation or pulseless ventricular tachycardia. In this case, the rhythm is SVT, and the client is not in cardiac arrest, so defibrillation is inappropriate.
D. Vagal maneuvers: Vagal maneuvers, such as carotid sinus massage or the Valsalva maneuver, are first-line interventions for stable SVT. However, in unstable clients with severe symptoms or hemodynamic compromise, these measures are insufficient, and synchronized cardioversion is urgently required.
Correct Answer is B
Explanation
A) Unilateral upper extremity weakness:
Guillain-Barré Syndrome (GBS) typically presents with bilateral weakness, not unilateral. The weakness in GBS typically begins symmetrically in the lower extremities and ascends upward toward the upper body, including the arms, face, and respiratory muscles. Therefore, unilateral weakness is not characteristic of GBS, and its presence should prompt further investigation into other possible causes.
B) Bilateral ascending weakness:
One of the hallmark signs of Guillain-Barré Syndrome is ascending weakness, which means that the weakness usually starts in the lower extremities (legs) and progresses upwards to the upper extremities, face, and potentially the respiratory muscles. This bilateral ascending paralysis is a classic feature of GBS and occurs due to the immune system attacking the myelin sheath of peripheral nerves. The nurse should be vigilant for signs of progressive weakness, as GBS can quickly lead to respiratory failure and requires prompt intervention.
C) Mask-like facial expressions:
Mask-like facial expressions are more commonly associated with Parkinson's disease, not Guillain-Barré Syndrome. Parkinson’s disease is characterized by a reduction in facial expressiveness due to the loss of dopaminergic neurons, leading to a fixed, unblinking, or "masked" appearance. While facial involvement can occur in GBS as the weakness ascends, it is not typically described as a "mask-like" expression.
D) Pill rolling actions made by the client's fingers:
Pill-rolling is a characteristic tremor often associated with Parkinson's disease and involves the repetitive motion of the fingers, as if rolling a pill. It is a resting tremor seen in Parkinson's disease and not in Guillain-Barré Syndrome. GBS primarily presents as weakness and loss of motor function, rather than tremors or other involuntary movements.
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